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Home My WebLink AboutX2022-1414 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-1414 rrj.r•iYrk . Tr 100 Civic Cen er Drive, Newport Beach, CA 92660 X 2 0 2 2 1 4 1 4 Project No : 1316-2022 W, Permit Counter Phone (949)644-3288 a.' .it Inspection Requests Phone (949)644-3255 Issued Date Combination Type - CIP MECH ELEC PLUM Inspection Area : 7 PERMIT EXP ES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY OR PERMIT WILL BE INVALID Construe 'on Hours: Monday- Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 2122 BRISTOL ST NB Description: COMM DEMO PRI R TO TI "STARBUCKS" Legal Desc.: N TR 706 LOT 141 Owner: SCHIFFMAN TODD I TR Contractor: SERVCO INC Architect: COUPER DOUGLAS� 18009 SKY PARK #E Address: 24315 AIRPORTER WAY Address: 9229 W SUNSET BL D, STE 501 Address: IRVINE CA 92614 LAGUNA NIGUEL CA 92677 it WEST HOLLYWOO CA 90069 Phone: 949-955-2300 Phone: 949-296-0450 State Uc:CO25874 C Phone: 714-885-3924 -0 Applicant: ANDERSON AMBEF Con State Lie: 937164 Engineer: Address: Address: 30 EXECUTIVE PAR K STE 100 Lie Expire: 08/31/2023 ro IRVINE, CA 92614 Bus Lie : BT30059160 Phone: State Lie: Phone: 949-285-4760 Lie Exp Date: 07/31/2022 Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: Carrier: EVEREST PREMIER Address: �„./ 0 Occupancy Group: B Policy No: 7600021913211 Added /New sq.ft. Bldg: 0 Expire: 10/20/2022 Phone: Added /New sq. ft. Garage: 0 1 Building Setbacks Rear: / Special Conditions: No of Stories: No of Units : 0 Front: / Bldg Height: 0 Left: I Bldg Sprinklers: Use Zone: Right: / Parking Spaces: 0 Fire Hazard Zone : N Flood Zone: X Construction Valuation: 4 000.00 Building Permit Fee: $690.0 Excise Tax: $0.00 Planning Department - $52.00 Fire Department Fire Inspection: $0.00 Plan Check Fee: $600.30 Additional Fee : $0.00 $0.00 Plan check Fee : Fair Share : $0.00 Fire Plan Rev $0.00 Overtime Plan Ck: $0.0 Fee: $0.0 Grading Bonds Fee: Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Investigation Record Management: $0.0 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 General Service $0.00 Energy Compliance: $0.0 Grading PC Fee: $0.00 $0.00 Public Works Department - Park Dedication : $0.00 Refund Deposit $0.00 CA Seismic Safety: $0.0 WQ Insp. Fee : PAN Plan Check: $0.00 Grading Bond: $0.00 Disabled Access : $0.0 Hazardous Mat $0.0 Electrical %: $0.00 San Dist : $0.00 $0.00 Building Green Fee : $2.0 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 TOTAL FEE $1,344.30 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $1,344.30 PUBLP: WORKS APPROVAL: PROCESSED BY: PLAN CHECK BY: ZONING APPROVAL: i , .,9RPROVALTO ISSUE: GRADING APPROVAL: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from Iicensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot lega11, sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 ) of ivisi n 3 of the Business and Pro ss' / a 1 ense isfull force and effect. License Class License No Date ontractor Signature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for e of the work for which this permit is issued. Policy No. have and maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' 'ance ca Nier a policy numbW-^ ^ (' h , 1 \Pgicy,tru�r _ Expiration Date of certify that, in the performance of the work far which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre t, if I should become su jact to Orkers'�ddgmper�ation pro/visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant 44 �O A� Q {� Date CLARATION REG DING C ING AGENCY :reby affirm under analty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, ivil Code). Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. 4exihl� I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or count t enter the above -identified property for inspection purposes.�nature of Property Owner or Authorized Agent X Print Prooertv Owner's or Authorized Aaent's Nat ACTION DATE BY I R GU RATIOS OF CO 1 LI ANCE 4ITH CODE OF RULEFEDERAL I FOR OFFICE USE ONLY PERMIT EXPIRED LJ I SUB TIED ASBESTOS NOTIFICATION TO PERMITCANCELLED UEPA PERMITEXTENDED J. _L.]Anmri CERTIFICATE OF OCCUPANCY ISSUED